Effects of mandibular advancement device for obstructive sleep apnea on temporomandibular disorders: A systematic review and meta-analysis

Anna Alessandri-Bonetti, Francesco Bortolotti, Isabel Moreno-Hay, Ambra Michelotti, Massimo Cordaro, Giulio Alessandri-Bonetti, Jeffrey P. Okeson

Research output: Contribution to journalReview articlepeer-review

14 Scopus citations

Abstract

The clinical practice guidelines do not give precise indications on the use of mandibular advancement devices (MAD) for obstructive sleep apnea (OSA) patients when they suffer from temporomandibular disorders (TMD). The aim of this systematic review was to evaluate the effects of MADs on prevalence of TMD signs and symptoms in adult OSA patients. The study protocol was registered under the PROSPERO register and an electronic search was performed in several databases. All types of studies evaluating TMD prevalence on adult patients wearing MAD for OSA were included and independently evaluated by two investigators. The quality of evidence was evaluated using the grading of recommendations assessment, development and evaluation and the risk of bias by the risk of bias in non-randomized studies of interventions tool or the Cochrane collaboration's tool. For each study included, the difference in means and 95% CI was calculated between baseline and follow-up. Twelve studies were included. The meta-regression analysis showed that patients with pre-existing signs and symptoms of TMD do not experience significant exacerbation of symptoms using the MAD. The presence of TMD does not appear to be routine contraindication for the use of MAD used for the management of OSA.

Original languageEnglish
Article number101211
JournalSleep Medicine Reviews
Volume48
DOIs
StatePublished - Dec 2019

Bibliographical note

Publisher Copyright:
© 2019 Elsevier Ltd

Keywords

  • Mandibular advancement device
  • Obstructive sleep apnea
  • Oral appliances
  • Sleep disorders
  • Temporomandibular disorders

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Neurology
  • Clinical Neurology
  • Physiology (medical)

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